Surgical ligature applicator



W. STICHS SURGICAL LIGATURE APPLICATOR Aug. 11, 1953 Filed NOV. 3, 1951 1 m0 m6 515 a 3 6(\ WW5? W HELMST/CHS Patented Aug. 11,1953

SURGICAL LIGATURE APPLICATOR Wilhelm Stichs, Hanau (Main), Germany, as-

signor, by mesne assignments, of one-third to The Elwood Research Company, a division of Chiselhurst, Inc., Newark, N. J., a corporation of New Jersey Application November 3, 1951, Serial No. 254,715

6 Claims.

My invention relates generally to surgical instruments and particularly with a clamp forceps to be used in applying clamps to the intestines or other internal portions of the human body during the performance of operations thereon.

Various devices have been known for use in applying surgical clamps to the human body tissues. Some of these devices operate by picking up each individual clamp and then crimping it into place as desired. Obviously, these devices have the disadvantage of consuming valuable time at a moment when such time is of the essence during an operation and are further disadvantageous in requiring repeated handling of the clamps.

It is an object of my invention to provide an improved clamp forceps. It is a further object of my invention to provide a clamp forceps wherein a plurality of clamps are held within the forceps and successively supplied to the clamping end of the forceps. A still further object of my invention consists in providing a surgical clamp which can be inserted into the magazine of a forceps and held therein until ready for use.

Further objects and advantages will hereinafter appear from a consideration of the accompanying drawings and the description thereof forming a part of this application in which:

Fig. 1 is a front view of the clamp forceps of the invention, 7

Fig. 2 is a cross-sectional view of a portion of the forceps,

Fig. 3 is a partial rear view of the forceps in loading position,

Fig. 4 is a cross sectional view taken on line 4-4 of Fig. 3,

Fig. 5 is a bottom view of one of the clamp arms,

Fig. 6 shows a packet of clamps,

Fig. '7 indicates one form of surgical clamp usable with my forceps,

Fig. 8 indicates a modification of a surgical clamp usable with my invention,

Fig. 9 is a detailed view disclosing the seating arrangement of a clamp on the lower end of a clamp arm.

Fig. 10 is a modification of a stop pin for the lever arms,

Figure 11 is a side view of the stop pin of Figure 10, and

Figure 12 is a cross-sectional view of a modification of the magazine mounting.

In accordance with my invention a magazine type of forceps is provided to receive a packet of surgical clips whereby each clip is successively fed to the clamping arms by a clip feeder member and the clip feeder member is held by the clam arms when the last clip has been expelled from the magazine. This device requires onlya single pair of clamping arms which are separable to an extent suflicient to allow for the reception of a magazine therebetween containing a strip of clips. The device of my invention provides a smooth clamping surface thus allowing for the use of the instrument in small incisions as well as in all body depths. It is further possible to apply the device to bleeding places which are practically inaccessible to known forms of clip forceps such as in cicatrized tissue or deformed tissue to enable a clamping of a blood vessel and a speedy cessation of any blood flow.

As shown in Figs. 1 and 2 the forceps consists of a tubular handle I having a cap member 8 mounted on its upper end as at 5. The lower end of handle I is fixedly mounted in a tapered housing- 4 as at 28. Aflixed to the cap member and extending downwardly from the cap 8 is a guide rod- 6 which is adapted to slidably fit within and telescope within a guide tube 9. Aflixed at 29 as by a soldered connection and extending below thehousingl is a hollowmagazine member 3. Asshownin Figs. 1 and 4 the magazine 3 has a generally rectangular cross-sectional form but has opposed upper and lower raised portions 32 and 33., The guide tube 9 has a clip feeding member ll afiixed at its lower end to slidably engage the inner walls 3l of the magazine 3. A spring I0 is coiled around the telescopic guide means 6, 9 and bears at one end against the inner portion of cap Band at the other end on head H. .The head II is provided on its lower end with a recess I 3 and two tapered surfaces l2,

[2 leading therefrom for the reception of a surgical clip as hereinafter explained in greater detail. I

Mounted upon the pyramidical shaped housing 4 as by screws I in threaded openings l5 are two spring-like clamping arms}, 2. E ach clamping arm 2 has a flat upper portion 22 and a thicker gripper portion provided with a serpentine surface as at It to assure a firm grip by the surgeon using the device. The lower end ll of each clamping arm is substantially right-angularly ex-,

tending to provide a crimping portion l8. The

crimping portion I 8 is fork-like shaped to provide a recess ll (Fig. 5) for the reception of the pointed end 5| of a surgical clip (Fig. 9).

The spring like clamping arms are provided with a leverage means as shown in Fig. 3 to pivotally support the lower ends thereof. Affixed by pivot pins 39, 40 are links 31, 38 one to each clamp arm. The links 31, 38 are pivotally pinned together by a stop pin 36 which slides within a longitudinal slot 35 in the raised portion 32 of magazine 3. This leverage means 60 thus allows the clamping arms to be opened and closed according to the extent of slot 35 and to approach each other in a linear path in symmetrical motion. A lock bar 4| is pivotally mounted on magazine 3 as at 42 and provides .a

shoulder stop 6| which when positioned in the path of movement of stop pin 36 prevents further outward movement of the lower ends ll of the clamping arms to prevent complete exposure of the open end of magazine 3. The lock bar is held in its locked position by a means consisting of a teat-like protuberance 44 formed on the under upper side of bar 4| which is adapted to seat in a depression 43 formed on portion 32 of magazine 3. The clamping arms each have a stop I! aifixed at the lower inner end I! adapted to bear against the sides 3| of magazine 3.

The feeder member I has a threaded opening |4 therein for the reception of a guide pin 20 which is adapted to slide within alongitudinal slot 30 in the raised portion 33 of magazine 3.

The surgical clips used may have a generally oval form as shown in Figs. '7 and 8 and are preferably supplied on a double pronged pin 55 having pointed hairpin ends 56 in the form of a package.

A simple clip comprises'a flat spring steel 52 having looped ends 53, 53 and downwardly extending prongs 5|, 5| as shown in Fig. 7. Alternatively the clip 50 may have looped ends 54, 54 and is extended upwardly to form two springlike extending arms 56, 56. The upper arms 56 are fastened to the lower portion at 55 of clip 50 (Fig. 8). The arms 56, 56 provide an easily accessible gripping means forreleasing and removing the clamps from the body.

The forceps are loaded by first withdrawing the feeder member into the magazine by grasping guide pin 20 and compressing spring Ill. The lock bar 4| is then released to allowfor the spreading of the clamping arms 2 to uncover I the lower end of magazine 3 and allow for the depositing of the surgical clamps within the magazine. When the magazine is filled the lock. bar is moved to closed position with the teat 44 in the depression 43 to bring the lower portions ll of the clamping arms below the openingof the magazine.

In the loaded position a surgical clip is seated on inner portions 25, 26'of the crimping portion IS with prong 5| projecting through recess 2| (Figs. 5, 9). In order to apply the clip to the body the arms 2, 2 are brought together to crimp the clip into position and as the arms are released the spring loaded feeder member ejects the crimped clamp from the forceps and simultaneously feeds a new clamp to the seat 25,26 of the clamp arms.

When the final clip is ejected from the magazine the feeder member H is prevented from ejectment from the magazine by guide pin 20 sliding to the lower end of slot 30 and against the magazine portion 33 and simultaneously the portion |2 of the member seats on portion 26 of the clamp arms.

The surgica1 clamps shown in Figs. '7, 8 have looped ends providing eyes to receive the prongs of the double pin 55. These clamps-must be loaded one by one into the magazine inorder to be properly positioned against'crimping portions I8.

The guide pin 20as heretofore disclosed is rigidly assembled to member H and therefore during the loading operation must be held depressed while each clip is loaded into the magazine. The guide pin 20 may therefore have a cross bar swivelly mounted thereon which can be rotated into a position to rest within an-enlargement at the upper end of slot 30 to latch the feeder member in open position in order to relieve the user from holding the feeder member down against spring pressure during the loading operation.

The type of clips and crimping means disclosed provide a proportionate movement of the clamping arms to crimp the clips onto the human body in such a manner that the clip lies adjacent the tissues and is not humped up to present a source of inflammation as is the case with some known types of surgical clips now in use.

The forceps with a loaded magazine are sterilized in a well known manner to those skilled in the art in a sterilizing solution and are then immediately available for use.

The device of my invention is particularly advantageous in that all the clips to be used by the forceps are made sterile simultaneously with the sterilization of the forceps and consequently each individual clip need not be sterilized separately and a higher degree of care is provided since each individual clip need not be repeatedly grasped by the forceps.

A further degree of cleanliness maybe provided by supplying exchangeable loaded steri-' lized magazines which can be simply inserted and withdrawn from the prismatically shaped housing 4 instead of being rigidly affixed thereto. In this arrangement the stop pin 36 is formed-as shown in Figs. 10 and 11 with afixed cross portion 36a, which can be rotated to place portions 36a into alignmentwith the slot 35 so that the leverage means may readily be assembled and disassembled into the magazine 3 as they are exchanged. Obviously the soldered connection of the magazine in the housing 29 would be replaced by a spring type of latch similar to the means 43, 44 on lock bar 4| or otherequivalent mechanical spring-like latching means which per se are known to the mechanical elements art. Alternatively the screws 1, 1 may be made long enough to fit through anextendedhole Ii' to thread into an exchangeable magazine 3 as shown in Fig. 12.

Although the clip forceps and clips andmodifications thereof for use in the inventionhave been illustrated and described, it will be apparent to those skilled in the art that'various other changes and modifications may be made therein without departing from the spirit of the invention or'from the scope-of-the appended claims.

What I claim is:

1. Clip forceps of the magazine'type,'comprising a hollow substantially rectangularly shaped:

magazine adapted to; containclips; a clipi'feeder member within saidimagazine'spring urged feed ing means mounted within said magazine and arranged to urge'said feeder member towardoneend of said magazine, a pair of clamping arms aflixed to the-upper'portion of said forceps and extending in spaced substantially parallel-relationship with saidmagazine one on each side thereof, said'arms including crimping portions at'the lower ends thereof, .a longitudinal guide slot in said magazine, a-guide pinslidable in said-slot, leverage-means including a pair of solidlinks pivotally mounted at one end, one on each of saidarms adjacent-the lower ends thereof, said links being pinneditogethertosaid:

guide pin at their other ends, said links being of equal length and so proportioned as to allow for the spreading of the crimping portions of the clamping arms to uncover the open end of the magazine, and lock means mounted on said magazine including a shoulder stop portion positionable in the path of movement of the guide stop pin to prevent complete outward movement of the arms.

2. The forceps of claim 1 wherein a hollow handle means is 'afiixed to the upper end of the magazine, the feeding means include a guide tube afiixed to the clip feeder and slidable therewith Within the magazine, said clamping arms being afiixed to the handle means, a stop pin fastened to the feeder member, a second longitudinally extending slot on the side of said magazine opposite from the first mentioned slot and spaced from the lower end of the magazine, the stop pin being slidable within the second slot.

3. The forceps of claim 2 wherein the lock means comprise a lock bar pivotally mounted at one end on said magazine below and in alignment with said second slot, said lock bar having a shoulder stop formed between its ends.

4. The forceps of claim 3 including latch means mounted on the lock bar and the magazine to fixedly retain the bar and its shoulder stop in the path of movement of said stop pin.

5. The forceps of claim 4 including means for releasably mounting said magazine within said handle portion and means for releasably mounting the guide pin within said first slot.

6. The forceps of claim 1, wherein a hollow handle portion is positioned above the upper end of the magazine, and means for releasably mounting said magazine within said handle portion.

WILHELM STICI-IS.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 948,456 Le Witt Feb. 8, 1910 1,203,269 Richter Oct. 31, 1916 FOREIGN PATENTS Number Country Date 788,980 France Aug. 5, 1935 

